文章：

多发性骨髓瘤患者心血管风险的管理

Management of cardiovascular risk in patients with multiple myeloma

原文发布日期：2019-02-26

DOI: 10.1038/s41408-019-0183-y

类型: Review Article

开放获取: 是

英文摘要：

Multiple myeloma (MM) is a plasma cell malignancy that accounts for 10% of hematological cancers. It predominantly affects elderly people; median age at diagnosis is 70 years. Consequently, many patients with MM have cardiovascular comorbidities or risk factors. MM can cause cardiac comorbidities such as cardiomyopathy and heart failure caused by cardiac amyloidosis and/or anemia. Some of the treatments used in MM can also affect cardiovascular health. Advances in pharmacotherapy for MM, such as the introduction of immunomodulators, proteasome inhibitors, histone deacetylase inhibitors, and monoclonal antibodies, have dramatically improved progression-free survival and life expectancy, but new agent classes are associated with adverse events that were not previously observed on a regular basis, including cardiovascular events. However, with careful risk assessment, monitoring, and prophylactic therapy, many of these cardiovascular complications can be managed or treated successfully. Most routine cardiovascular surveillance is undertaken by the treating hemato-oncologist, but a multidisciplinary approach involving cardiologists may help to optimize patient outcomes. In this review, we survey the cardiac complications commonly reported in patients with MM, discuss how they can be prevented and managed, and summarize the role cardiologists can play in delivering the best possible outcomes for patients with MM and cardiovascular comorbidities.

摘要翻译： 

多发性骨髓瘤（MM）是一种浆细胞恶性肿瘤，占血液系统恶性肿瘤的10%。该病主要影响老年人群，诊断中位年龄为70岁。因此，许多MM患者患有心血管合并症或危险因素。MM可导致心脏合并症，如由心脏淀粉样变性和/或贫血引起的心肌病与心力衰竭。部分MM治疗手段也会影响心血管健康。随着免疫调节剂、蛋白酶体抑制剂、组蛋白去乙酰化酶抑制剂及单克隆抗体等新型药物的应用，MM的药物治疗进展显著改善了患者的无进展生存期和预期寿命，但这些新药类别也带来了以往不常见的不良事件，包括心血管事件。不过通过仔细的风险评估、监测和预防性治疗，多数心血管并发症可以得到有效控制或治疗。常规心血管监测大多由血液肿瘤科医生完成，但联合心脏科医生的多学科协作模式有助于优化患者预后。本综述探讨MM患者常见的心脏并发症，阐述其预防与管理的策略，并总结心脏科医生在合并心血管疾病的MM患者最佳诊疗中可发挥的作用。

原文链接：

Management of cardiovascular risk in patients with multiple myeloma